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<br />EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: <br /> <br />CERTIFlCATEOFINSURANCE , <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br /> <br />PRODUCER: f0 ./ ?-Vol. -\ '2- <6 PUBUC ENTITY (ADDITIONAL INSURED) <br /> \'..I' L. \X>:z.- - D\{~ <br />Driver Allilll1t insuranCe Se1vices ~ - '2-<:::0" -oq '0 Cay 06 Sant:a. Ana: <br />P.O.Box28323 fJ ? 03 otl 20 c.i.v.i.c. C enteJL P la.ZIt, M-28 <br />SaJlla Ana, CA 92799-8323 - ~ - - Sant:a. Ana:, CA 92701 <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOWER): , EVENTlNFORl.fnTIm: . a1. SU'.6 <br /> I TYPE: nil c..Uo n - ImplLovemetl-t <br />VarUU'. Ac.hatz DATE(S): I/Ub/U~ - IZ/j,/U) <br /> LOCATION: S.A. JlUt <br />This is 10 certify that !:be policies of insuraDce-listed below have been issued to !:be insured named above for the policy period <br />indic8ied. NotwithstaDdiDg lUIY nquiremeub, lcnns or conditions of lUIY contnCt or other document with respect to wbich this <br />certificalcmay be issued <lC JDllY pertaiD, the insuraDce afforded by the policies described he:ein is subject to all the terms, <br />exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanstan Insurance ~y <br />MASTER POLICY NUMBER: OSSEPlOOOOOI <br />MASTER POLICY DATES: EFFECTIVE: JANUARY I, 2005 EXPIRATION: JANUARY 1,2006 <br />COMMERCIAL GENERAL UABUJTY OCCURRENCB FOIlM DEDUCTIBLE: NONE <br />Cl<u<nl JlUnP" Umil $ 2.000.000 <br />Prod_ '" Complelod Operations 1.000.000 <br />P.....w '" Advatisins lniurY 1.000.000 <br />_ 0ccuna1ce Limi. 1.000.000 <br />Fire Domoso{AnlOnefire) 50.000 <br />Mocfic:aI hymen.. (Any One Penon) 5.000 <br /> . <br />The Ii.... or insurance .""Iy ,,,,,,,"Iy 10 each....'"-oI by ,hi. polie:)' IS if. ocpoI1I" policy ofinounonce hIS been iuucd for that event <br />"Who i. insured" ;.1IIlClldcd 10 ioch>dt, .. OIl insured, tile pcl'S<lI1 or orpnization _ in tbia ",hodule, hul only with reopecllO liahilil)' lIrioinl out of tile <br />ownc:rsbip, main1CNnCe or ... of tho premi...1lIcd by tile _ inIURd (event hoId...~ Thi. _ does not apply to: Any~""""""",,," which Iakco place <br />Iftortlle....,1 ho1d<r cea,es Io'he ,tenonl in that <br /> OTHER ADDmONAL INSUREDS <br /> , <br />CANCEl LA TION- Should tho above des<nbcd policy 10 cancelled before: the expiration date 1Il....,f, tho muinB """",,"y will mailJO d.,.. written notice 10 tile <br />urtiflc:ate holder and additional in_listed. <br /> <br />AUl'HORlZED REPRESENT A TlVB: <br /> <br />~;Z~ <br /> <br />c.-/.' . <br />/~'<)I - - .(, - <br />- L "'-t- (," t'~ I <br />v, _ _ / <br /> <br />DATE ISSUED: <br /> <br />Janu.M.Y 6, 2005 <br />